A Study on the correlation between platelet indices and severity score in acute ischemic stroke
Background: Acute ischemic stroke results from the sudden loss of blood circulation to an area of cerebral hemispheres leading to irreversible brain injury and neurological deficits persisting for more than 24 hours or until death. It accounts for 80-87% of all strokes. The present study aimed to find the association between various hematological indices such as Mean platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet to Lymphocyte ratio (PLR), and National Institute of Health Stroke Scale (NIHSS).
Methods: It was a prospective study done at the Department of Medicine at Great Eastern Medical School and Hospital in which 80 patients with Acute Ischemic stroke were divided into two groups basing on the NIHSS score. Proper Exclusion criteria were carried out and the patients' blood samples were taken. Various Platelet and hematological indices were measured and statistical analysis was done using SPSS Software.
Results: There is a positive correlation between PLR and NIHSS scores. It is a statistically significant association. But there is no statistical significance between Platelet indices and NIHSS score.
Conclusion: Being Low cost and easy to measure the nature of PLR, these indices can be used in the prediction of the prognosis in Acute Ischemic Stroke Patients.
Ga D. Fisher M, Macleod M, Davis SM. Stroke. Lancet. 2008;371(9624):1612-1623. doi: 10.1016/S0140-6736(08)60694-7.
Adams Jr HP, Del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38(5):1655-1711. doi: 10.1161/CIRCULATIONAHA.107.181486.
D'Agostino RB, Wolf PA, Belanger AJ, Kannel WB. Stroke risk profile: adjustment for antihypertensive medication. The Framingham Study. Stroke. 1994;25(1):40-43. doi: 10.1161/01.str.25.1.40.
Ovbiagele B, Nguyen-Huynh MN. Stroke epidemiology: advancing our understanding of disease mechanism and therapy. Neurotherapeutics. 2011;8(3):319-329. doi: 10.1007/s13311-011-0053-1.
Banerjee TK, Das SK. Fifty years of stroke researches in India. Ann Indian Acad Neurol. 2016;19(1):1-8. doi: 10.4103/0972-2327.168631.
Lloyd-Jones D, Adams R, Carnethon M, Simone GD, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics 2009 update: a report from the American Heart Association statistics committee and stroke statistics subcommittee. Circulation. 2009;119(3):e21-181. doi: 10.1161/CIRCULATIONAHA.108.191261.
Giovanetti T, Nascimento A. Platelet Indices: Laboratory and Clinical Applications. Revista Brasileira de Hematologia e Hemoterapia 2011 33(2):164-165. doi:10.5581/1516-8484.20110040.
Pizzuli L, Yang A, Martin JF, Luderitz B. Changes in platelet size and count in unstable angina compared to stable angina and non-cardiac chest pain. Europe Heart J. 1998;19(1):80-84. doi: 10.1053/euhj.1997.0747.
Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996;7(2):157-161.
Enticknap JB, Gooding PG, Lansley TS, Avis PR. Platelet size and function in ischaemic heart disease. J Atheroscler Res. 1969;10(1):41-49. doi: 10.1016/S0368-1319(69)80080-3.
Jagroop IA, Mikhailidis DP. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Brit J Haematol. 2003;120(1):169-170. doi: 10.1046/j.1365-2141.2003.03983_4.x.
Dougherty Jr JH, Levy DE, Weksler BB. Platelet activation in acute cerebral ischaemia: Serial measurements of platelet function in cerebrovascular disease. The Lancet. 1977;309(8016):821-824. doi: 10.1016/s0140-6736(77)92774-x.
Toghi H, Suzuki H, Tamura K, Kimura B. Platelet volume, aggregation and ATP release in cerebral thrombosis. Stroke. 1991;22(1):17-21. doi: 10.1161/01.str.22.1.17.
Smith NM, Pathansali R, Bath PM. Platelets and stroke. Vasc Med. 1999;4(3):165-172. doi: 10.1177/1358836X9900400307.
Vagdatli, E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet Distribution Width: A Simple, Practical and Specific Marker of Activation of Coagulation. Hippokratia. 2010;14(1):28-32.
Kim JY, Park J, Chang JY, Kim SH, Lee JE. Inflammation after ischemic stroke: the role of leukocytes and glial cells. Experiment Neurobiol. 2016;25(5):241-251. doi: 10.5607/en.2016.25.5.241.
Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S, et al. Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke. 2008;39(2):355-360. doi: 10.1161/STROKEAHA.107.490128.
Arbel Y, Birati EY, Finkelstein A, Halkin A, Berliner S, Katz BZ, et al. Red blood cell distribution width and 3-year outcome in patients undergoing cardiac catheterization. Journal of Thromb Thrombolysis. 2014;37(4):469-474. doi: 10.1007/s11239-013-0964-2.
Kasama T, Miwa Y, Isozaki T, Odai T, Adachi M, Kunkel SL. Neutrophil-derived cytokines: potential therapeutic targets in inflammation. Curr Drug Targets-Inflammation Allerg. 2005;4(3):273-279. doi: 10.2174/1568010054022114.
Tekesin A, Tunç A. Inflammatory markers are beneficial in the early stages of cerebral venous thrombosis. Arquivos de Neuro-Psiquiatria. 2019;77(2):101-105. doi: 10.1590/0004-282x20190001.
Lok U, Gulacti U, Ekmekci B, Bulut T, Celik M. Predictive and prognostic role of mean platelet volume in patients with first-ever acute ischemic stroke. Neurosci. 2017;22(2):119-126. doi: 10.17712/nsj.2017.2.20160330.
Muscari A, Puddu GM, Cenni A, Silvestri MG, Giuzio R, Rosati M, et al. Mean platelet volume (MPV) increase during acute non-lacunar ischemic strokes. Thromb Res 2009;123(4):587-591. doi: 10.1016/j.thromres.2008.03.025.
George J. A study on risk factors of patients with acute ischemic stroke at a tertiary care hospital. Int J Med Health Res. 2017;3(11):99-101.
Mayda-Domaç F, Misirli H, Yilmaz M. Prognostic role of mean platelet volume and platelet count in ischemic and hemorrhagic stroke. J Stroke Cerebrovasc Dis. 2010;19(1):66-72. doi: 10.1016/j.jstrokecerebrovasdis.2009.03.003.
Al-Tameemi W, Ameen MM. Significance of Platelet Indices in Patients with Acute Ischemic Stroke. The Iraqui Journal of Agricultural Sci. 2012;10(4):383-389.
Butterworth RJ, Bath PM. The relationship between mean platelet volume, stroke subtype and clinical outcome. Platelets.1998;9(6):359-364. doi: 10.1080/09537109876429.
Ghahremanfard F, Asghari N, Ghorbani R. The relationship between mean platelet volume and severity of acute ischemic brain stroke. Neurosci. 2013;18(2):147-151.
Shah P, Mir R, Kamili M. Role of Mean Platelet Volume in Ischemic Stroke. JK Sci. 2013;15(3):136-139.
Sung PH, Chen KH, Lin HS, Chu CH, Chiang JY, Yip HK. The correlation between severity of neurological impairment and left ventricular function in patients after acute ischemic stroke. J Clin Med. 2019;8(2):190. doi: 10.3390/jcm8020190.
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